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Superficial and Deep Situated Fibromatoses: Similar Histomorphologic Appearance but Different Biological Behavior

Yıl 2013, Cilt: 4 Sayı: 16, 1 - 9, 03.03.2015

Öz

Aim: Fibromatoses are a locally infiltrative soft tissue tumors being situated superficial or deep tissues and usually treated by surgical excision. The surgical local control of these tumors, especially ones arising from deep tissues, remains a significant problem. On this study, we aimed to investigate the clinical, histopathological and immune staining features of superficial and deep fibromatoses diagnosed our laboratory. Material and methods: Consecutive twelve cases diagnosed as fibromatoses between January 2005 to December 2013 were included to the study. Patients' ages, sex, the localization of tumor, the tumor size, histomorphological features and immune staining profiles of tumors were investigated. Statistical analyses were performed using Mann–Whitney U and Chi-Square/Fisher's Exact test. Results were considered to be significant at p < 0.05. Results: Four cases were superficial-seated, and 8 cases were deep-seated fibromatoses. The age of patients ranged from 18 to 72 (mean 62.5). All of superficial fibromatoses were male. All of deep fibromatoses were female. No recurrence was observed on superficial tumors. Three (37.5%) of deep-seated tumors had recurrent. The size of superficial tumors ranged from 1.5 cm to 4.5 cm (mean: 3.5 cm). The size of deep-seated tumors ranged from 1.5 cm to 15 cm (mean: 9 cm). There was no statistically significant difference between the two groups, in terms of the patients' age (p= 0.173), the recurrence rate (p= 0.491), Ki-67 proliferation index (p = 0.248) and immune staining for desmin (p= 0.491), smooth muscle actin (p= 0.091), S-100 protein (p= 0.515), Ki-67 (p = 0.236). Statistically, a significant correlation was observed between the two groups, in terms of the gender (p= 0.002) and the tumor size (p= 0.042). Conclusion: The histomorphological appearance and immune staining characteristics of superficial and deep-seated fibromatoses are similar. However, the clinical features and in terms of biological behavior of these two entities seems to be different from each other

Kaynakça

  • Kruse AL, Luebbers HT, Grätz KW, Obwegeser JA. Aggressive fibromatosis of the head and
  • neck: a new classification based on a literature review over 40 years (1968–2008). Oral and
  • maxillofacial surgery. 2010;14(4):227-32.
  • Salas S, Dufresne A, Bui B, Blay J-Y, Terrier P, Ranchere-Vince D, et al. Prognostic factors
  • influencing progression-free survival determined from a series of sporadic desmoid tumors: a waitand-
  • see policy according to tumor presentation. Journal of Clinical Oncology. 2011;29(26):3553-8.
  • Stout AP. Juvenile fibromatoses. Cancer. 1954;7(5):953-78.
  • Kreuzberg B, Koudelova J, Ferda J, Treska V, Spidlen V, Mukensnabl P. Diagnostic problems
  • of abdominal desmoid tumors in various locations. European journal of radiology. 2007;62(2):180-5.
  • Molloy A, Hutchinson B, O'Toole G. Extra-abdominal desmoid tumours: a review of the
  • literature. Sarcoma. 2012;2012.
  • Bonvalot S, Eldweny H, Haddad V, Rimareix F, Missenard G, Oberlin O, et al. Extraabdominal
  • primary fibromatosis: aggressive management could be avoided in a subgroup of patients.
  • European Journal of Surgical Oncology (EJSO). 2008;34(4):462-8.
  • Stoeckle E, Coindre J, Longy M, Bui Nguyen Binh M, Kantor G, Kind M, et al. A critical
  • analysis of treatment strategies in desmoid tumours: a review of a series of 106 cases. European
  • Journal of Surgical Oncology (EJSO). 2009;35(2):129-34.
  • Tolan S, Shanks J, Loh M, Taylor B, Wylie J. Fibromatosis: benign by name but not
  • necessarily by nature. Clinical Oncology. 2007;19(5):319-26.
  • El-Haddad M, El-Sebaie M, Ahmad R, Khalil E, Shahin M, Pant R, et al. Treatment of
  • aggressive fibromatosis: the experience of a single institution. Clinical Oncology. 2009;21(10):775-80.
  • Mullen JT, DeLaney TF, Kobayashi WK, Szymonifka J, Yeap BY, Chen Y-L, et al. Desmoid
  • tumor: analysis of prognostic factors and outcomes in a surgical series. Annals of surgical oncology.
  • ;19(13):4028-35.
  • Bertani E, Testori A, Chiappa A, Misitano P, Biffi R, Viale G, et al. Recurrence and
  • prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its
  • limitations. World Journal of Surgical Oncology. 2012.
  • Escobar C, Munker R, Thomas JO, Li BD, Burton GV. Update on desmoid tumors. Annals of
  • Oncology. 2012;23(3):562-9.
  • Catton C, O'Sullivan B, Bell R, Cummings B, Fornasier V, Panzarella T. Aggressive
  • fibromatosis: optimisation of local management with a retrospective failure analysis. Radiotherapy and
  • Oncology. 1995;34(1):17-22.
  • Colombo C, Gronchi A. Desmoid-type fibromatosis: What works best? European Journal of
  • Cancer. 2009;45:466-7.
  • Ozger H, Eralp L, Toker B, Agaoglu F, Dizdar Y. Evaluation of prognostic factors affecting
  • recurrences and disease-free survival in extra-abdominal desmoid tumors. Acta Orthop Traumatol
  • Turc. 2004;41(4):291-4.
  • Sleijfer S. Management of aggressive fibromatosis: Can we unravel the maze of treatment
  • options? European Journal of Cancer. 2009;45(17):2928-9.
  • Quintini C, Ward G, Shatnawei A, Xhaja X, Hashimoto K, Steiger E, et al. Mortality of intraabdominal
  • desmoid tumors in patients with familial adenomatous polyposis: a single center review of
  • patients. Annals of surgery. 2012;255(3):511-6.
  • Ioannidis O, Paraskevas G, Chatzopoulos S, Kotronis A, Papadimitriou N, Konstantara A, et
  • al. Multiple desmoid tumors in a patient with familial adenomatous polyposis caused by the novel
  • W421X mutation. Revista espanola de enfermedades digestivas: organo oficial de la Sociedad
  • Espanola de Patologia Digestiva. 2012;104(3):146-50.
  • Huss S, Nehles J, Binot E, Wardelmann E, Mittler J, Kleine MA, et al.
  • β‐Catenin(CTNNB1)mutations and clinicopathological features of mesenteric desmoid‐type
  • fibromatosis. Histopathology. 2013;62(2):294-304.
  • Kohli K, Kawatra V, Khurana N, Jain S. Multicentric synchronous recurrent aggressive
  • fibromatosis. Journal of Cytology. 2012;29(1).
  • Kempson R, Fletcher C, Evans H, Hendrickson M, Sibley R. Atlas of tumor pathology.
  • Tumors of the soft tissues Washington, DC: AFIP. 2001.
  • Rüdiger HA, Ngan SY, M N, GJ P, PF C. Radiation therapy in the treatment of desmoid
  • tumours reduces surgical indications. Eur J Surg Oncol 2010(36):84–8.
  • Gluck I, Griffith KA, Biermann JS, Feng FY, Lucas DR, Ben-Josef E. Role of Radiotherapy in
  • the Management of Desmoid Tumors International Journal of Radiation Oncology, Biology, Physics.
  • ;80(3):787-92.
  • Gounder MM, Lefkowitz RA, Keohan ML, D’Adamo DR, Hameed M, Antonescu CR, et al.
  • Activity of Sorafenib against Desmoid Tumor/Deep Fibromatosis. Clinical Cancer Research.
  • ;17(12):4082–90.
  • Constantinidou A, Jones RL, Scurr M, Al-Muderis O, Judson I. Pegylated liposomal
  • doxorubicin, an effective, well-tolerated treatment for refractory aggressive fibromatosis. European
  • Journal of Cancer. 2009;45(17):2930-4.
  • de Camargo VP, Keohan ML, D'Adamo DR, Antonescu CR, Brennan MF, Singer S, et al.
  • Clinical outcomes of systemic therapy for patients with deep fibromatosis (desmoid tumor). Cancer.
  • ;116(9):2258-65.
  • Baumert BG, Spahr MO, Von Hochstetter A, Beauvois S, Landmann C, Fridrich K, et al. The
  • impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients.
  • A study of the Rare Cancer Network. Radiat Oncol. 2007;2(1):12.

YÜZEYSEL VE DERİN YERLEŞİMLİ FİBROMATOZİSLER: BENZER HİSTOMORFOLOJİK GÖRÜNÜM ANCAK FARKLI BİYOLOJİK DAVRANIŞ

Yıl 2013, Cilt: 4 Sayı: 16, 1 - 9, 03.03.2015

Öz

Amaç: Fibromatozisler yüzeysel ya da derin
yerleşimli olabilen ve çoğunlukla cerrahi eksizyon ile
tedavi edilen, lokal infiltratif yumuşak doku
tümörleridir. Özellikle derin yerleşimli
fibromatozislerin cerrahi ile lokal kontrolü sorun teşkil
etmektedir. Bu çalışmada laboratuarımızda
fibromatozis tanısı alan yüzeysel ve derin yerleşimli
olguların klinik, histopatolojik ve immün boyanma
özellikleri karşılaştırılmıştır.
Gereç ve yöntemler: Ocak 2005 ile Aralık 2013
tarihleri arasında fibromatozis tanısı alan 12 olgu
çalışmaya alındı. Hastalarda yaş, cinsiyet, tümör
yerleşimi, tümör boyutu, tümörlerin histomorfolojik
ve immün boyanma özellikleri karşılaştırıldı.
İstatistiksel analizlerde Mann–Whitney U ve Chi-
Square/Fisher's Exact testi kullanıldı. p < 0.05
sonuçlar anlamlı kabul edildi.
Bulgular: Fibromatozis tanısı alan olguların 4'ü
yüzeysel, 8'i derin yerleşimli idi. Hastaların yaşı 18 ile
72 arasında değişmekteydi (ortalama 62,5). Yüzeysel
yerleşimli olguların hepsi erkek, derin yerleşimli
olguların hepsi kadındı. Yüzeysel yerleşimli
tümörlerde nüks izlenmezken derin yerleşimli
olgulardan 3'ü (%37,5) nüksetmişti. Yüzeysel
yerleşimli tümörlerin boyutu 1,5 cm ile 4,5 cm
arasında değişmekteydi (ortalama 3,5 cm). Derin
yerleşimli tümörlerin boyutu 1,5 cm ile 15 cm
arasında değişmekteydi (ortalama 9 cm). İstatistiksel
analizde tümör lokalizasyonu ile cinsiyet (p= 0,002)
ve tümör boyutu (p= 0,042) arasında anlamlı ilişki
saptandı. Tümör yerleşim yeri ile yaş (p= 0,173), nüks
oranı (p= 0,491), desmin (p=0,491), düz kas aktin (p=
0,091), S-100 protein (p=0,515), Ki-67 (p= 0,236)
immün boyaları ve Ki-67 proliferasyon indeksi
(p=0,248) arasında anlamlı ilişki görülmedi.
Sonuç: Yüzeysel ve derin yerleşimli fibromatozislerin
histomorfolojik görünümü ve immün boyanma
özellikleri birbirine benzerdir. Ancak klinik özellikleri
ve biyolojik davranışları açısından bu iki antite
birbirinden farklı gibi gözükmektedir.

Kaynakça

  • Kruse AL, Luebbers HT, Grätz KW, Obwegeser JA. Aggressive fibromatosis of the head and
  • neck: a new classification based on a literature review over 40 years (1968–2008). Oral and
  • maxillofacial surgery. 2010;14(4):227-32.
  • Salas S, Dufresne A, Bui B, Blay J-Y, Terrier P, Ranchere-Vince D, et al. Prognostic factors
  • influencing progression-free survival determined from a series of sporadic desmoid tumors: a waitand-
  • see policy according to tumor presentation. Journal of Clinical Oncology. 2011;29(26):3553-8.
  • Stout AP. Juvenile fibromatoses. Cancer. 1954;7(5):953-78.
  • Kreuzberg B, Koudelova J, Ferda J, Treska V, Spidlen V, Mukensnabl P. Diagnostic problems
  • of abdominal desmoid tumors in various locations. European journal of radiology. 2007;62(2):180-5.
  • Molloy A, Hutchinson B, O'Toole G. Extra-abdominal desmoid tumours: a review of the
  • literature. Sarcoma. 2012;2012.
  • Bonvalot S, Eldweny H, Haddad V, Rimareix F, Missenard G, Oberlin O, et al. Extraabdominal
  • primary fibromatosis: aggressive management could be avoided in a subgroup of patients.
  • European Journal of Surgical Oncology (EJSO). 2008;34(4):462-8.
  • Stoeckle E, Coindre J, Longy M, Bui Nguyen Binh M, Kantor G, Kind M, et al. A critical
  • analysis of treatment strategies in desmoid tumours: a review of a series of 106 cases. European
  • Journal of Surgical Oncology (EJSO). 2009;35(2):129-34.
  • Tolan S, Shanks J, Loh M, Taylor B, Wylie J. Fibromatosis: benign by name but not
  • necessarily by nature. Clinical Oncology. 2007;19(5):319-26.
  • El-Haddad M, El-Sebaie M, Ahmad R, Khalil E, Shahin M, Pant R, et al. Treatment of
  • aggressive fibromatosis: the experience of a single institution. Clinical Oncology. 2009;21(10):775-80.
  • Mullen JT, DeLaney TF, Kobayashi WK, Szymonifka J, Yeap BY, Chen Y-L, et al. Desmoid
  • tumor: analysis of prognostic factors and outcomes in a surgical series. Annals of surgical oncology.
  • ;19(13):4028-35.
  • Bertani E, Testori A, Chiappa A, Misitano P, Biffi R, Viale G, et al. Recurrence and
  • prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its
  • limitations. World Journal of Surgical Oncology. 2012.
  • Escobar C, Munker R, Thomas JO, Li BD, Burton GV. Update on desmoid tumors. Annals of
  • Oncology. 2012;23(3):562-9.
  • Catton C, O'Sullivan B, Bell R, Cummings B, Fornasier V, Panzarella T. Aggressive
  • fibromatosis: optimisation of local management with a retrospective failure analysis. Radiotherapy and
  • Oncology. 1995;34(1):17-22.
  • Colombo C, Gronchi A. Desmoid-type fibromatosis: What works best? European Journal of
  • Cancer. 2009;45:466-7.
  • Ozger H, Eralp L, Toker B, Agaoglu F, Dizdar Y. Evaluation of prognostic factors affecting
  • recurrences and disease-free survival in extra-abdominal desmoid tumors. Acta Orthop Traumatol
  • Turc. 2004;41(4):291-4.
  • Sleijfer S. Management of aggressive fibromatosis: Can we unravel the maze of treatment
  • options? European Journal of Cancer. 2009;45(17):2928-9.
  • Quintini C, Ward G, Shatnawei A, Xhaja X, Hashimoto K, Steiger E, et al. Mortality of intraabdominal
  • desmoid tumors in patients with familial adenomatous polyposis: a single center review of
  • patients. Annals of surgery. 2012;255(3):511-6.
  • Ioannidis O, Paraskevas G, Chatzopoulos S, Kotronis A, Papadimitriou N, Konstantara A, et
  • al. Multiple desmoid tumors in a patient with familial adenomatous polyposis caused by the novel
  • W421X mutation. Revista espanola de enfermedades digestivas: organo oficial de la Sociedad
  • Espanola de Patologia Digestiva. 2012;104(3):146-50.
  • Huss S, Nehles J, Binot E, Wardelmann E, Mittler J, Kleine MA, et al.
  • β‐Catenin(CTNNB1)mutations and clinicopathological features of mesenteric desmoid‐type
  • fibromatosis. Histopathology. 2013;62(2):294-304.
  • Kohli K, Kawatra V, Khurana N, Jain S. Multicentric synchronous recurrent aggressive
  • fibromatosis. Journal of Cytology. 2012;29(1).
  • Kempson R, Fletcher C, Evans H, Hendrickson M, Sibley R. Atlas of tumor pathology.
  • Tumors of the soft tissues Washington, DC: AFIP. 2001.
  • Rüdiger HA, Ngan SY, M N, GJ P, PF C. Radiation therapy in the treatment of desmoid
  • tumours reduces surgical indications. Eur J Surg Oncol 2010(36):84–8.
  • Gluck I, Griffith KA, Biermann JS, Feng FY, Lucas DR, Ben-Josef E. Role of Radiotherapy in
  • the Management of Desmoid Tumors International Journal of Radiation Oncology, Biology, Physics.
  • ;80(3):787-92.
  • Gounder MM, Lefkowitz RA, Keohan ML, D’Adamo DR, Hameed M, Antonescu CR, et al.
  • Activity of Sorafenib against Desmoid Tumor/Deep Fibromatosis. Clinical Cancer Research.
  • ;17(12):4082–90.
  • Constantinidou A, Jones RL, Scurr M, Al-Muderis O, Judson I. Pegylated liposomal
  • doxorubicin, an effective, well-tolerated treatment for refractory aggressive fibromatosis. European
  • Journal of Cancer. 2009;45(17):2930-4.
  • de Camargo VP, Keohan ML, D'Adamo DR, Antonescu CR, Brennan MF, Singer S, et al.
  • Clinical outcomes of systemic therapy for patients with deep fibromatosis (desmoid tumor). Cancer.
  • ;116(9):2258-65.
  • Baumert BG, Spahr MO, Von Hochstetter A, Beauvois S, Landmann C, Fridrich K, et al. The
  • impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients.
  • A study of the Rare Cancer Network. Radiat Oncol. 2007;2(1):12.
Toplam 70 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Original Articles
Yazarlar

Hasan Gökçe

Serhat Toprak Bu kişi benim

Tümay Özgür Bu kişi benim

Esin Doğan Bu kişi benim

Mehmet Yaldız Bu kişi benim

Seçkin Akküçük Bu kişi benim

Raif Özden Bu kişi benim

İbrahim Yetim Bu kişi benim

Aydıner Kalacı Bu kişi benim

Muhyittin Temiz Bu kişi benim

Yayımlanma Tarihi 3 Mart 2015
Gönderilme Tarihi 3 Mart 2015
Yayımlandığı Sayı Yıl 2013 Cilt: 4 Sayı: 16

Kaynak Göster

Vancouver Gökçe H, Toprak S, Özgür T, Doğan E, Yaldız M, Akküçük S, Özden R, Yetim İ, Kalacı A, Temiz M. YÜZEYSEL VE DERİN YERLEŞİMLİ FİBROMATOZİSLER: BENZER HİSTOMORFOLOJİK GÖRÜNÜM ANCAK FARKLI BİYOLOJİK DAVRANIŞ. mkutfd. 2015;4(16):1-9.